Arch Osteoporos. 2026 Apr 23;21(1):70. doi: 10.1007/s11657-026-01704-x.
ABSTRACT
Brief rationale: Low bone mineral density may be linked to cardiovascular risk, but causality is unclear.
MAIN RESULT: In 1233 individuals followed for 14 years, osteoporotic fractures and trabecular vBMD independently predicted cardiovascular events, while areal BMD did not. Significance of the paper: Bone health could be associated with the development of cardiovascular events.
PURPOSE: In this observational cohort of a general population sample, we aimed to assess the association between bone mineral density (BMD) and osteoporotic fractures on the risk of subsequent cardiovascular events in both sexes.
METHODS: This prospective study included 1233 individuals (mean age 62.5 ± 8.4 years; 76% women) from the Camargo cohort in Northern Spain, followed for 14.3 ± 4.0 years. Baseline clinical data, DXA-based BMD (lumbar spine, femoral neck, total hip), trabecular bone score (TBS), and volumetric BMD by 3D-DXA were analyzed. Incident cardiovascular events (myocardial infarction, stroke, peripheral artery disease) were documented. Cox regression analyses were performed adjusting for cardiovascular risk factors.
RESULTS: During follow-up, 240 participants (19.5%) experienced cardiovascular events. These individuals were older and had higher rates of hypertension, diabetes, dyslipidemia, smoking, atrial fibrillation, and previous cardiovascular event. A history of osteoporotic fracture was more frequent among those with cardiovascular events (9.6% vs. 3.1%, HR 2.59). Lower trabecular vBMD and TBS were observed in the event group, while areal BMD showed no significant differences. Adjusted analyses revealed that a history of osteoporotic fracture independently increased cardiovascular risk by 125% (HR 2.25; 95% CI 1.43-3.54). Moreover, for each 1 SD increase in trabecular vBMD, the risk was slightly reduced by 14% (HR 0.86; 95% CI 0.74-0.99).
CONCLUSIONS: Our findings indicate that prior osteoporotic fractures and trabecular vBMD are significant predictors of cardiovascular event risk, independent of traditional risk factors.
PMID:42024227 | DOI:10.1007/s11657-026-01704-x